There are over 100 different types of congenital heart disease. This concept brings together a group of anomalies and morphological structure of the heart and large vessels. Anomalies are resulting from the breach or incomplete formation (embryogenesis) of the heart and large vessels in utero, at least postnatal development.
The frequency of congenital heart disease varies from 5 to 8 cases per 1000 live births (0,5- 0, 8%). Among all the cardiac defects are the most common defects of the interventricular septum. Without prompt treatment, most children with congenital heart disease die within 1-2-year life. Only 10-15% of them live 2 years or more.
Congenital disorders of the cardiovascular system are usually the result of improper fetal development of heart failure or progressive development of its structures for achieving the early stages. Malformations are usually a consequence of a number of genetic and environmental factors. Only in rare cases it is possible to single out any one cause.
Classification of heart defects is rather complex. In earlier classifications (clinical features) they were separated by defects with cyanosis (“blue” defects), and no cyanosis.
Currently, clinically significant cardiac defects divided by the nature of hemodynamic disorders in the pulmonary circulation into the following groups: malformations overflow of the pulmonary circulation; vices with depletion him with the vices unchanged blood flow. In the first and second groups are isolated defects with cyanosis and without cyanosis of the skin.
By the vices of the first group are open arterial duct, defect of atrial septum, aortic coarctation, and others. To vice, accompanied by cyanosis, include tricuspid valve atresia with a normal caliber of the pulmonary trunk and a large ventricular septal defect, patent ductus arteriosus with a drain blood from the pulmonary artery into the aorta. This is observed in severe hypertension in the vessels of pulmonary circulation.
By the vices of the second group are not accompanied by cyanosis, are isolated stenosis of the pulmonary artery trunk.
By the vices of the third group with unchanged blood flow in the vessels of the lungs include anomalies of the aortic arch and its branches, the absence of the aortic arch, stenosis, and coarctation of the aorta, mitral atresia, atresia of the aortic valve, mitral insufficiency, and other more rare malformations.
There are as combined malformations, in which the violations identified relationships between the various divisions of the heart and large vessels.
In patients with malformations of the first group there is a message from the intracardiac pathologic discharge of blood from the arterial to the venous (from the left ventricle of the heart and large vessels, and off directly from him, from left to right), so in the peripheral arterial bed comes insufficient number of arterial blood. In this regard, children lag behind in physical development, often suffer from pneumonia, skin them pale, sometimes with a pointed bright color lips. Pallor increased after physical load. For all the flaws of this group is typical overflow with blood (hypervolemia) of the right heart and pulmonary vessels.
The second group includes the vices which there is depletion of the pulmonary circulation with blood (hypovolemia) due to the difficulty of its release of the right ventricle to the pulmonary artery system, such as stenosis of the pulmonary artery. With moderate narrowing of the pulmonary artery in children often lack the subjective sensations caused by a vice, and children usually develop satisfactorily. With a significant narrowing of the pulmonary artery is experiencing weakness, fatigue, pain in the heart, shortness of breath on exertion. Skin color in these children is normal, is often observed a “heart hump”.
In patients with malformations of the third group the symptoms of disorders of gas exchange are absent. The main complaints in these patients are fatigue, palpitations, and headaches. If coarctation of the aorta in patients older than 14-15 years experienced higher blood pressure at the upper and lower on the lower extremities. Skin and visible mucous membranes is of normal color.
Cardiovascular disorders occur in approximately 1% of all live births. With early detection of vice accurate diagnosis of anatomical anomalies in the present no difficulties and most children can be saved with medical or surgical treatment.